Episode 2. Integrated care in the fields of sexual assault, domestic and family violence

The second episode of Making Visible highlights the importance of an integrated responses to sexual assault, domestic and family violence and all forms of child abuse and neglect, including children and young people with problematic and harmful sexual behaviours. Mim and Lis reflect on the impact of coercive control and how the dynamic of a violent relationship presents itself in a therapeutic environment. Listen to the first practitioner explain the theory and the framework, as the second practitioner story provides clear examples of working with people over a lifetime with impact of intergenerational violence and complex childhood trauma.

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Welcome to Making Visible, preventing, and responding to violence, abuse, and neglect. The podcast supporting you to deliver best practice in your work with people who have experienced domestic and family violence, sexual assault, child abuse, and neglect. The Agency for Clinical Innovation acknowledges the traditional owners of the lands that we live and work on. We pay our respects to elders past, present, and emerging and extend that respect to other Aboriginal people here and listening today. We would also like to acknowledge those with lived experience. We recognise and appreciate consumers, patients, carers, supporters, and loved ones. The voices of people with lived experience are powerful their contribution is vital to enabling decision-making for health system change. Information about accessing personal support is available in the show notes and at the end of each episode.(MUSIC PLAYS) This series is about preventing and responding to violence. We are Making Visible. This is a series that is about preventing and responding to abuse. We are Making Visible. This is a series about preventing and responding to neglect. We are Making Visible. From the Agency for Clinical Innovations. We are Making Visible. Violence, Abuse and Neglect Network. We are Making Visible. In collaboration with the University of Wollongong. We are Making Visible. And the Social Work Stories podcast. We are Making Visible. SPEAKER: This is Making Visible. We are Making Visible. Preventing and responding to violence, abuse and neglect. We are Making Visible. This is Making Visible. Hello everyone, and welcome to episode two of Making Visible. Hello, Liz. Hello, Mim. How are you? Yeah, really, really well, and excited to be here for episode two. I'm Dr Mim Fox and joined with me, Liz Murphy. We are here to really talk about preventing and responding to violence, abuse, and neglect. This is another great episode where I know I found my mind expand in relation to the work, the PARVAN clinician, or the team. That's right. So, this is an episode where we're going to really go deep into domestic and family violence and we're gonna look at the violence, abuse, and neglect sector. Liz. And actually, how do all the pieces work together in this space? Speaking of pieces, I really like the way that we're going to present these two different stories because they fit as pieces so well together. So, the first story we're going to have a wonderful explanation of Parveen, but also the eroding impact of coercive control, from what I must say, sounds like a wonderful, positive, enthusiastic clinician. Look, I'm impressed that there's an enthusiastic domestic and family violence clinician out there. Liz, I've got to say, because it's heavy work, this one, right? Like this is actually the sort of work that takes a range of skills. What you're actually needing to embody as a practitioner every day is really diverse. And so, I really like the fact that the first story we're gonna tell isn't necessarily even a classic story. It's actually a review of the theoretical basis to our understandings around coercive control. And to me, it actually gives us a way to sort of witness and listen to the story of the violence and abuse and neglect sector that we're then going to move into. Yeah, And I think through that lens, through listening to this clinician explained the erosion that can happen when a person's experiencing domestic violence, especially coercive control, is a wonderful lens to listen to the next story, which is more a classical case example of the complex work that a PARVAN clinician does. That's right. And for our listeners who are out there thinking, but what is PARVAN? We're gonna get into that and let our clinicians tell you actually, because I think this is such an unique experience actually working in the space that now is the sector itself. So, we're gonna hear from them. Firstly, let's now move on to listening to our domestic and family violence clinician really give us that grounding in these spaces. So, as a domestic violence counsel, I just see women who've experienced domestic violence. They might be still in the relationship they might have left. They might be thinking of leaving, they might be thinking of returning. So, what's actually. What do we actually do in that space. And why don't women leave in the first place? So, I guess I wanted to lean into this because there's lots of different perceptions out there in the media, and I thought maybe a bit of what I could share might uncover some of those or bust some of those myths, really. So, I guess when you think about DV at the moment, you really hear the pointy end through the media about strangulation or you hear about women being punched or women being murdered. And I guess when you think about it in that context, you think, well, then why hasn't she left? Like she was almost about to be murdered or she's been strangled or this really hectic level of violence. But I guess what is good to understand is that it's sometimes not even about the physical violence. It's about really coercion and control. And that's, I guess, a huge factor as to why women don't leave. And it's also a huge factor in what we actually do in therapy. So, I guess I'll just unpack coercion and control. When I think about coercion control, I think about it as a tactic. Something that someone is doing to impact someone's freedom, to impact someone's satisfaction in life, and impact somebodies independence and their happiness. So then, how people do that, how people use coercion, control, might be things like psychological abuse, financial abuse, social abuse, and it comes in all different forms. And I guess the pattern that I've seen over time and time and time again is that I have a woman walk into my office and every woman that walks in is different. There might be old, young, rich, poor, with kids, without kids, it doesn't matter. But the pattern of the males behaviour when it comes to coercion and control is always the same. Often they will woo the women when they first meet them. They will love bomb them with gifts and flowers. They'll take advantage of their values if the woman is very caring and loving, they will then expose those values and really, really try to get in and under the woman's skin with her values. And then once they're in there, they then start using this coercion and control, and it can look really different for different clients. I guess some examples I've seen with some of my clients might be, a woman. One of my clients might have had problems with alcohol in the past. And then she meets this guy and he's super supportive and really caring. And he looks like he really wants to support her and love her. But then in doing that, he also is saying to her, oh, look, you can probably just have one drink. You'll be fine. Now, I'll look after you. Well, maybe you can have two drinks, or maybe you can have three. And then the next thing you know fast forward a year or two years, and she's back being a full-blown alcoholic and he's supplying the alcohol for her. And in doing that, keeping her in this kind of reduced capacity states that she doesn't have full function. She can't make all the decisions that she needs to make to keep herself safe. And this man has used her vulnerability to then control her I guess another example I see quite a lot is again, woman meets man. Man at first is so loving and wants to get to know all her family and be part of her community, be part of her social group, be part of her cultural group. And she's thinking, oh, how amazing is this guy, wanting to integrate with my wider network, which is so important to me? And then as the relationship continues on, he then starts kind of isolating her within those wider groups. He's sound. Spreads rumours about her being like a slut or just shaming her, saying she's cheating on him, she's got drugs or alcohol problems, she's spending all their money. So, we spreading these rumours and therefore isolating her from all those people that were close with her, but also in the same context, making her the only person she can rely on. And this is really, really common. Another kind of example of this kind of coercion and control and how it looks is, you might have a guy who's at first really open with his communication and he's like, look, babe, I just wanna talk to you all the time. I wanna like, call you and text you. I think it's really great if we just kind of share our social media. Really, really wanna be transparent. But then that just kind of escalates and escalates and escalates. And next thing you know, the guy's sending her up to 100 messages a day and she's completely suffocated from this man. And he's on her social media accounts, he's on her phone, he's connecting with her friends, and she's got nowhere she can go without him bombarding her. And I guess these are just the subtle ways coercion and control, meaning impacting someone's freedom, their happiness, their independence can really affect someone's sense of self-worth and their self-esteem. And I guess that's what it comes to in terms of what we do in counselling. So part of me. There's always like my, I guess, personal hat. I've got my work hat and my personal hat. My personal hats like, oh, just leave him, he's terrible. He's harassing you. But then I guess when I think about in a professional context, if I think about my life and all the people who have influenced me, my friends, my family, and the huge role they have in my world, it'd be silly for someone to say, just leave him. And also, if I was to ever say that to a woman, I would then be replicating the same behaviour as a perpetrator. I would be coercing her, I'd be controlling her. I'd be telling her, you need to do something. And that's exactly what the perpetrator does. So really, in therapy, it's a slow, slow process of just peeling back the layers of an onion to kind of get to the heart of a woman's self-esteem and self-worth and really let her develop her sense of identity again. Who was she before she met him? What were the ideas she had about love? What were her values or ideas about family, about friends? And how did he impact those? And how can we get her back to the way she was or even better? So, it's a really delicate and slow process of healing and like healing. It's kind of like a lifelong journey. So, therapy might finish, but she'll continue to grow and develop and I guess, learn from those experiences for the rest of her life. And that's something I've definitely learnt with all of my clients over the years that I've been working with them. So, I guess in the room, in the therapy room, a lot of what we're talking about really, also includes feeling safe. When you've had someone in your world who has made you feel like you're on shifting sand, who has always moving the goalposts. So, you don't know if you're right. If you're wrong, you don't know if you're coming or going. Essentially what that is, is your sense of safety. Women don't need to be punched in the head or strangled to not feel safe. We've all, as individuals, walked into a room before and felt, oh, a bit uncomfortable, or, oh, this doesn't feel right. That is your internal system, your central nervous system telling you you don't feel safe. And when women have lived in relationships with their central nervous system or their internal system which regulates their sense of safety, has been on high alert for so long, it then impacts your physical health, your mental health, your overall well-being. So, a lot of what we do in therapies, starting to understand how our body works and how not feeling safe has impacted us previously and how it's still impacting us today. So, a really even small example of this might be a woman who's not felt safe for a really long time, might have a really big, what we call startle response. So, I might go get a cup of tea, come back into the therapy room, and say, oh, hello. And she will go, oh! Straight away. She'll get a big fright because her system is on red alert. It's ready to respond. So, part of what we do in therapy is pooling our systems back down and kind of pulling out our central nervous system back down to where it feels comfortable and safe so that she can walk in the world without feeling that she's gonna be harmed from others or that there's danger around every corner. And a lot of that work is about being mindful, mindful of your body, mindful of your brain, and slowly integrating the thoughts that we have with the feelings that come up from our body. It's a slow process and it takes time, but I have definitely seen clients come out the other side feeling a lot better and a lot more grounded and a lot more improved sense of safety in doing this work. So, I think that's the real hope. Is that in therapy there is hope that women actually can start to walk on their, I guess, journey of recovery, which is really, really satisfying to work with. I sit here and I think about when I was working in domestic violence maybe 12 years ago, and I celebrate how we have grown in terms of our understanding around domestic violence. And I loved how this clinician was able to really just nail it in relation to the impact of coercive control and how eroding that is of the woman in terms of the colonising of time, of their space, of their social circles, how they isolate the woman and how it impacts on all levels for the woman and possibly a family if there's a family involved. Such a sophisticated understanding, which I hope helps some of our listeners to really understand what takes, what is the dynamic that can take place in a violent relationship. Yeah, absolutely. And from the dynamic to then understand how that presents in a therapeutic environment, right? So, that, the way that this clinician was speaking about the body and how the body plays out the emotional impact. Right. And it plays out the trauma because actually when someone comes into the therapeutic space, often that's how it's being demonstrated. Often the words aren't there to explain what's happening to them. But I like the way she describes it. That's part of her role. Absolutely. Is around giving voice. SPEAKER: Yes. To what's taking place in the embodiment of that trauma with some of her clients. That's right. And every woman feels that they're the only one experiencing it. And I think it was really interesting to actually be able to hear this clinician globalise some of this and say, well, here are some of the ways that it always plays out, right? Nine times out of 10, this is what it is. And I think that's really fascinating like to be able to say, well, here's the theory. Here's how we understand these issues. And now he is how we can work with it. The other issue I wanted to pick up or that struck out, for me Mim was the way in which she talked about the work being slow work. Hmm. SPEAKER: This takes time. Yeah. This type of therapeutic work takes a lot of time. And I'm hoping that some of the people who are perhaps not therapists, but maybe managed services or trying to understand what these services do, increase in knowledge around that this does take time. I remember when I was practising that sometimes you do occasionally get a manager that did say, eight sessions per person, then get them off the list. I was gonna say that, Liz. I was gonna say what, you don't think you can take out sessions? Really?(LAUGHS) It's tragic, right? But it is actually still happening. So, you're absolutely right. There's a lot of learning to be had around how much time change in this space actually takes. Look, the story we're gonna hear now from another clinician actually really demonstrates that it actually really demonstrates how you can work with people over a lifetime and still be working on the issues that were caused from the trauma from their childhood. Right. One of the things before we kick off into this story, Liz, is that there are some quite detailed telling around child sexual abuse and around domestic and family violence. So, just a shout-out about that content. And then the other thing is just to really think about for our listeners, the story. This story starts 20 years ago. It was a really different environment then. And the world of PARVAN now is very much one with an integrated care approach Liz, where services work together, where they're not siloed. OK. So, listening in on this story, it shows the difference in time, what time can do actually, and what policy change can achieve, I think. And how systems can work together to better keep a family or children safe, one would hope. I also. One of the things that we like to do sometimes Mim, is encouraging people to listen to the different skills and knowledge that's identified by the clinician in their work with these. Well, with this family, really, I mean, I would love to kind of brainstorm all of the different therapeutic modalities she talks about in her work with the two girls, but also some of the other skills, the advocacy work, the. I would imagine, referral work. There's a whole lot of things that I want us to talk about afterwards. That one was identified, but also some of the things that we know that would have also been happening that perhaps weren't talked about. Yeah. Because there's so many layers of the story. That's exactly right. So, everyone have a listen. And let's see, let's see whether you can hear what we can hear in terms of the interventions that are actually happening. Just before we do just once again, this story does contain details around child sexual abuse. It does contain details around violence and neglect. So, please take care of yourselves in the listening and we'll here on the other side. I'm a sexual assault counsellor in a small rural town in New South Wales. I'm part of a larger PARVAN team, PARVAN stands for prevention and response to violence, abuse, and neglect. And that includes sexual assault counsellors, child protection counsellors, domestic violence services. And I cover a large geographical area which includes five smaller towns. I work with anyone who has experienced a sexual assault, regardless as to how recent or how long ago the sexual assault occurred. They don't need to have gone to the place to see me. Where an adult makes a disclosure of sexual assault. It's up to them. If they would like to report that to the police or not. All disclosures of child sexual assault are investigated by police. Single-incident abuse is often the exception rather than the norm, and people often experience multiple forms of violence and abuse, either co-occurring or over their lifetime. I'm also privileged to run groups with victims of sexual assault and domestic violence. Today, I'm going to talk to you about Beth and Maggie, who are 26 and 24. Now, that's not their real names, but that's the name that I'm going to use for them today. I met Beth and Maggie when I first started working as a social worker in this country town 20 years ago. Beth and Maggie's father had recently passed away, and they lived in a public housing home with their mum, who had a physical disability and also used drugs. Mom's new partner, Bob, also lived there. These girls were well known to services in this town since or about six and four years old. They were already seeing the sexual assault counsellor after being sexually assaulted by one of their mother's male friends who used to frequent the house and supply drugs to mum. So, the children lived with mum and mom's new partner, Bob. When the children were about seven and nine, they made disclosures that Bob was sexually abusing them to their sexual assault counsellor. The Department of Communities and Justice interviewed the children. A sexual assault belief was formed by them, and Bob was made to move out. However, over that weekend, their mum encouraged the girls to retract their statement to DCJ, Department of Communities and Justice, which they did the following week. And Bob, the stepfather moved back in. Mum then refused to allow her daughters to continue to see the sexual assault counsellor, and Beth and Maggie remained in the care of their mother and stepdad until Beth was 16 and Maggie was 15. They both suffered severe neglect. In that time, cockroaches were in their lounges. There was faeces and urine in their beds. The children had head lice and no food at school. Mum would leave the girls with Bob while she was out. So, the sexual abuse was ongoing, although they didn't make further disclosures in that time. Department of Communities and Justice were often involved. However, the children remained in their care, of mum and stepdad. At 16 Beth moved in with her paternal uncle in a nearby town. At 14, Maggie fell pregnant. Maggie wouldn't disclose who the father was to anyone. Maggie's mum and stepfather attended all the medical appointments with her, and they were even present during the birth. Maggie was 14 when she delivered her baby boy in the local hospital, and she then moved into her next-door neighbour's house. Her baby stayed mostly with mum and stepdad while she continued to attend school. When Maggie left school a few months later, she then took over the full-time care of her son. At 19 and 17, the girls disclosed to their paternal Uncle Bob had been sexually abusing them since they were four and six. They then made a full disclosure to police, and Maggie and Beth within referred to me as the sexual assault counsellor, which is where I saw them again. So, trust and rapport was super important to make Beth and Maggie feel safe in our counselling space. This was ongoing throughout the years that I would be providing counselling and support to this family. I provided lots of court preparation around the court processes that were going through, around giving evidence, the court layout, et cetera. It took about 18 months before it was heard in court. The stepdad was charged. He pleaded guilty and he was sentenced to 14 years jail with 11 years non-parole. Their mum was charged. She pleaded guilty also, and she was sentenced to 18 months jail. Mum since out of jail and returned to the same town that the two girls live in. Both girls suffered from severe anxiety, didn't find it easy to leave the house at all. They both suffered with chronic nightmares and flashbacks of the sexual assaults. Both Maggie and Beth had debilitating triggers. The smell of old men is still a significant trigger for them. Trying to identify the deodorant or lack of deodorant mixed with significant male body odour. Doing everything to avoid these triggers which would take them back to the bedroom and the re-experiencing of the sexual abuse. This re-experiencing of often feeling frozen in their everyday tasks. Sensory issues that neither of the girls were able to have physical contact with others, including their children, and able to physically cuddle their children once they turned about 12 months old. The sisters were very supportive of each other. Maggie was living with her boyfriend and the child of the stepdad. They also had another daughter together. Maggie's boyfriend was very abusive emotionally, socially, and financially. Maggie was very isolated. Where she lived, there was no public transport. She lived about 20 kilometres out of the main town. And Maggie did leave him after a couple of years. She still hasn't told her son about his paternity. And she is very worried about what will happen when the perpetrator is released from jail in a few years' time. Maggie did not engage with the sexual assault service for long after the court process finished. It was crucial in my role to provide lots of validation to both of the girls around their emotions, feeling guilty for putting their mother through everything. In their eyes, they had publicly embarrassed their mum, validation for also feeling angry and wishing they grew up in a family where they should have been loved and cared for and had the same nice things that they saw that their peers had. Validation of their anger towards services for not protecting them for all those years. Wondering why they were not removed. There was lots of skill in education around emotion, regulation, calming, breathing, mindfulness. We did cognitive behaviour therapy, challenging negative self-talk, trying to help them to calm their nervous system. Their many years of feeling so unsafe, their bodies and their minds did not believe that they were actually safe now. And to this day, both girls still don't feel safe. Beth went on to have four girls, all very close in age. Beth felt safe in her relationship with her partner, who she met when she was 17 years old. He has a slow, debilitating condition that will require 24-hour care as he gets older. Beth feels that she has an important role to care for him. Beth's partner, is, however, on the New South Wales Sex Offenders Registry as he was charged with a sex offence when he was 17. Beth defends this and minimises the significance of this. Beth is not believing that her partner is guilty of the charge. So, our counselling has involved lots of conversations about keeping her children safe, recognising grooming tactics. However, Beth is convinced that her children are safe with her partner. There hasn't been any disclosures to suggest otherwise. However, the children do have some significant behaviour concerns which are being followed up by paediatricians, social workers, and the school counsellors. Beth at one point in the past 12 months, was wanting to leave her partner and started to disclose to me some of his controlling behaviours. They said that he would put her down, telling her she would never cope on her own, even going so far as to contact the manager of our mental health service to say she was losing her mind. Her partner was trying to convince her that she didn't know what she was doing. This was to try and stop her from leaving him. Beth disclose to me that a partner was forcing her to have sex when she didn't want to. And Beth disclosed that he would ejaculate in her morning cup of tea that he would make for her. He would do this knowing that the smell of semen is debilitatingly triggering for her. This would see her immobilised for most of the day. Just when Beth seemed to recognise these coercive and controlling behaviours in her partner for what they were, she developed a sudden neurological condition, which now requires ongoing medical treatment. Beth now feels unable to leave him, and she feels she needs a husband to cope and manage their four children. So, some of the work Beth and I have done together, we've looked at physical and body safety. Her traumatic events had destroyed her assumptions about safety. We explored mindfulness together. We talked about Beth's alarm systems. We explored breathing strategies and imagery, trying to create a safe place in her mind, even if she couldn't find a safe place in her everyday life. These were skills that we had to revisit time and time again. The ongoing sexual assaults had a significant effect on how Beth felt about herself and her children, as well as her relationships with others and the beliefs that she had about herself and her community. Big issues for Beth continue to be trust. Her feelings of safety and intimacy in her relationship. Validation of Beth's sexual assault experiences are ongoing throughout our work. The window of tolerance was a tool we would often refer to looking at Beth's hypo and hyperarousal states. Always checking in where she was currently functioning, looking at what strategies she could use to bring herself back into a window if she was hyper-aroused or hypo aroused. Throughout our counselling journey, Beth and I have spent lots of sessions remembering the details of the sexual abuse, trying to attach the words and the feelings to the memories. There has been a lot of grieving experienced by Beth. Grieving for the childhood she wanted to have, the loving and protective parents she would have liked to have had, grieving her first sexual experience, and grieving what her life would have been had she not experienced this significant trauma. Beth has been able to name the trauma for what it was. She has been able to recognise where the responsibility of the trauma lies, not with her, but with her mother and his stepfather. We have been able to ceremonially hand back that responsibility to where it rightly belongs, taking away the burden and the weight that she has carried for her lifetime. The shame, however, still exists, and we're still trying to work on this. Beth has been very courageous in her willingness with our work together. Mim, sometimes we start with just tuning in to each other's reaction to listening to this story. And I'd like to do that with this story as well because it was hard to listen to. I don't know. Like, I guess I'm gonna flick it to you first. What is some of the reactions in the feelings that you experienced as you listened to the story of Beth and Maggie? Pure and utter frustration, Liz. And I have to say that I think I mimic the practitioner's frustration in telling the story. Some of our listeners might be thinking, why did the. Why was the practitioner making these short, sharp statements? Right. And I think really that speaks to me of the frustration of this long-term work where she has seen these children go through such an extended period of time and continue to be carrying the weight of the trauma with them as they go through their lives. Right. Every single decision that was happening with them as older as young adults was traced back to that original trauma. Right. And for me, I just. I felt frustrated by that. I felt frustrated by the lack of service, coordination, and provision around this case. And frustrated that as hard as this case was to listen to, it's one of many. Liz, this is classic sort of cases happening all the time for VAN workers. You felt frustrated. I think I might add mine up to my head exploded off my shoulders the first time I've listened to it. And in fact, I think the emotions initially got in the way of me listening to the many layers. I had to stop. Yeah. And go and put some clothes on the line when I first listened to this because I thought, I think I've got to smash something.(LAUGHS) Yes. I think I was being kind when I said frustration. OK. SPEAKER: Yeah. No. OK, fair enough. Fair enough. So, you too had very strong reaction to this? Yeah, absolutely. Absolute. My heart broke because I just know that having been the role of the cliche myself, the times when you think if only, if only this could have been a different story. Yeah. The redemptive work, the complex work would have been so much easier if certain things had of happened. And like you say, it really helped me to go. Right. Come on. Now, we've got to look at this through a historic lens, too. Yeah. 20 years ago, as you say, things were done differently. And I know you're right about, these things still happen. Of course they still happen. But I'd like to think about if the system works well together. Yes. If the system... Well, if there's a...(CROSSTALK)..integrated approach. SPEAKER: That's what I was going to say. If there's an integrated care approach, which now there is a focus on, because I can only imagine that part of the problem was. That that wasn't what was happening and that something fell through the cracks big time, that these girls remained in the care of their stepfather. Yeah. And I also wanna come back to the whole issue of, I mean, look, I note that the therapist talked about it, but I would bet my life on the fact that there was domestic violence going on as well as a sexual assault going on with the girls. Well, if you come back to what our initial clinician spoke about, the theoretical base around coercive control, a lot of the behaviours that were happening in the family wouldn't have been possible Liz if there wasn't coercive control with the mum happening. Right. Like, it's just not possible. And I think now that we have a much more sophisticated understanding of the tactics used. Yeah. By someone who's perpetrating violence, including both the coercive control that takes place, we move away from, I guess, just mother blaming, for instance. Yeah. That this is part of a really complex scenario. Part of the removing any protective factors was getting rid of mum. Yeah. Like. And there was the drug use that was going on. So, there was lots and lots of things that were happening that made it so, so unsafe for these girls to be living in this family. And I think that's what we were hearing in this clinician's voice as she's relaying this story to us. We can hear it. Yeah. Yeah, I think you're absolutely right. I think I wanna come back just to this integrated care idea as well because the clinician at the beginning of the story was giving the current context of PARVAN, right? So, it was giving that current context of all these systems working together. And when you go back through this story, there were many points where if we had an integrated care approach, these children could have been caught up, right? So, they coming into school, neglected, no food, lice, and living in this situation. Right. Nothing's being picked up. The child protection workers were working with them when they were children. The child made an allegation. It was later retracted. But actually, they just kept working with the family. But the children were never removed. Right. There were many points along the way or actually had the system spoken to each other. There could have actually been a much more directed, targeted intervention around the safety of these kids. Well, that old friend Bob would have been removed, not the children. That's right. But, yeah, look, look. Alright. So, moving away from her reactions, now it's time. It's time Liz. We could actually have an entire podcast on just our own. That would be... that's a different podcast, isn't it Liz? Is indeed. I wanted to move now Mim into the inter-generational violence that we witnessed in this one story. Yeah. And how interesting it is to have the one clinician that can actually tell this story from, you 20 years. I'm thinking. Yeah, she's tracked this family. So, she's seen the girls as children. Yeah. She has then seen them emerge as adults and being parents themselves. Yeah. And often we talk about what inter-generational violence can look like. Yeah. And this is a really, really clear example of how it can play out. What the next generation can be living with as a result of the trauma that they experienced as children. Yeah. Yeah. And then what is the work of a clinician in this area? Yeah, that's right. And just the completely debilitating impact of trauma. Right. The fact that one of the daughters still, now that she's an adult and has four children, still can get frozen by traumatic flashbacks and sensory overload. Right. Like, I think that for the clinician who's been working with this family for so long, I mean, it's a different thing, isn't it, where an adult comes to you and has to tell you the story of what happened. Right. But for her to have actually watched and witnessed the growth of these girls into adults while they've been dealing with ongoing trauma, it really does change the intervention in a way, I think, as well. And as I listen to you speak, I think, but how powerful for these young or this young woman now you're actually working with someone who can say, hang on there. Yeah. This is related to the trauma that you experienced when you were a child. And I liked how she said, sometimes we have to repeat these lessons, these conversations over and over again. But sometimes I would imagine when you have a relationship that's as long term as this, you can shorthand it. Yeah. SPEAKER: You know this. Yeah, that's right. And we we've spoken about that many times. In your life, yeah. SPEAKER: You know these. You know these. And so, I would imagine that makes the work really interesting, too, because there's the continuity, but there's also the current day issues that they're having to work on, too. And, we see now this contemporary life that this woman's living has its own challenges. Yeah, yeah. She's living in a relationship where there is coercive control being used, she has her own health issues. That's right. She's got the complex trauma that she's living as she's trying to parent within the context of these challenges. So complex, isn't it? And I just also wanna kind of pull out of this as well, the rural aspect to this story. They're in a rural area. One of the sisters as an adult now lives 20 kilometres out of town. Right. Doesn't drive. You can't get to where she's living without a car. Like it actually, then really allows for a coercive control space, right? Well, actually, the woman feels literally trapped in this scenario. And I can't help but think, like, as children, they're experiencing those. That's where the feelings have started from. That's the trauma. But as adults, that's what they know. And so with the therapist, what they're then the practitioner, what they're doing to try and interrupt that is actually to say just because it's what you know doesn't mean that's the way it has to be. There is another way to experience life. Right? Another way to parent. Yes. And another way to have relationships, right? Indeed. And in some ways, this practitioner who's known them for 20 years, he's going to be one of the fundamental relationships they've had. Right. With such a disruptive life with different levels of relationships. That really is kind of modelling in a way as well. This is a safe relationship. That's right. And I can work with you around the very, very complex parameters of your life at the moment. We can work together to look at ways to keep your children safe, which was not able to happen for you. That's right. But you can be that parent here, even given the fact that your partner is using coercive control. Yeah. But these are the ways that we can actually work together to help you to keep yourself and your children safe. Also, given the fact that there are some elements to this relationship that you require to live. Yes. I mean, we didn't go into the finances, but possibly that but her own health issue, he's now a carer. Again, Mim, doesn't it highlight the diverse and complex skill set of these PARVAN solutions. Absolutely. Well, they are at the same time facilitating these therapeutic conversations, as well as advocating for all of the needs of their clients as well as, case managing all the various aspects of their lives that are coming up. I mean, really, we're talking about a very varied skill set, right? We are, and so there's face-to-face stuff that goes on. Yeah. And maybe it's a 60-minute, 30-minute, weekly fortnightly session. So, there's that. But then there's also all the work that comes away from the face-to-face. Yeah. As you're saying, the advocacy work, the contacting police if there's been a domestic violence incident, there's the relationship that you have with the DCJ, with the child protection workers. Yeah. As a result of hearing something in the counselling session, like there is so many layers to the work, both face-to-face but away from. Yeah. And of course I would imagine there's really good supervision that's going on here. I think there would need to be Liz because to actually hold all those different roles and spaces at the same time. Well, actually, you could really understand if practitioners started to compartmentalise themselves as well and start to say, well, I'm really an advocate now, or I'm really a therapist, or you know what I mean? Like you could really see that happening because actually, it's a very large, varied space to hold. And for a really skilled clinician, they're gonna need to be able to do that. And so, you're gonna need supervision. Exactly. And whilst she may be working face-to-face with mother. Yeah. Or woman, always having to keep the children in the room. That's right. Always needing to have that child protection lens in the work that she's doing with. Yeah, the safety lens, right? The risk and safety lens. Yeah. And I wanna go back now to our initial emotional reaction, which was frustration. And if we're frustrated, imagine that practitioner, right? We spoke about how I said I was mirroring that practitioner's response and the way to actually process that frustration, to sit with it over such a long time. It's got to be done in supervision Liz. It's got to be done in supervision. And there are probably at times when there's debriefing that's needing to go on. Oh, absolutely. SPEAKER: Yeah. Instead of or in conjunction with the supervision. They needed, there would need to be an opportunity maybe with colleagues to would be able to let off steam and to be able to just talk through some of these complexities so they can get it clear in your head and your heart, Right? Yeah, yeah, yeah. But also to come back to the theory that our first story talked about and to ground yourself back in that in what you know, right, Because sometimes you can get so swept up in the complexity and then the associated emotions around what you're seeing happening in your clients' world. That coming back to that theory base and that framework, actually, you need another voice, an objective voice to bring you back there. And if this person or people who are doing similar work are working in isolation which can happen in rural areas really, really easily, right? Absolutely. This gives me the motivation to continue doing these kinds of podcasts. Yeah. Because it creates a virtual community as well, right? Yeah, yeah, yeah. That's yeah, that's yeah, absolutely. I know that we could talk about this for several more hours, but listeners, we're not going to because we do need to wind up. But I have a feeling this is one of these episodes that it's worth listening to a number of times because it demonstrates the complexity of the work of these PARVAN workers. It looks at the impact of trauma on through an intergenerational lens. Yeah. It looks at the work that needs to be done in relation to the redemptive work, but also the work of just supporting someone bearing witness to their story and being the safe relationship as well for this person, being the continuity, perhaps as this worker was in this woman's life, knowing that there is someone here who is borne witness to my life and is also there walking with me partly through this, through my, I guess, my growth, my recovery. So, just such important. And long as we've acknowledged, this is slow, long-term work. Yeah. And shout out to those workers who are doing the work, right? Like this is... (CROSSTALK) I am in awe and I'm so happy to be sitting on the sidelines just kind of going, this is amazing work. I've just feel really privileged that we get a chance to showcase that in this way. Slightly. Yeah, and I think one of these stories today described their work as privileged, right? And I think that's absolutely right. It's privileged work, but it's also a privilege for us to listen to it.(CROSSTALK) And thank you so much to these workers who are sharing the story with them. And so, that's end of episode two Liz. Episode three coming up, we're gonna keep going into domestic and family violence. Yeah, I would have thought that was enough. But no, because there's so much complexity. Right. So, we're gonna keep going in that really, really detailed work. We're gonna talk about domestic violence, and family violence, with a view on sibling sexual abuse, and then also a view on disability. And what happens when you bring in the extra variables, right, into this complex work? And then we're gonna talk a little bit about self-care, I think, as well, and supervision, which I think is really, really important. We got to go, go deeper into that for sure. One of those topics that you and I are just so passionate about. Yep, yep, yep. So, for all of you out there, social workers, psychologists, other health care professionals, however it is, you've come to this amazing work. You know you can stay up to date with innovations in the area by joining the Agency for Clinical Innovations, Violence, Abuse and Neglect Network. That great network, please come and be a part of the community. The website is in the show notes. So, call out to all of you. Come and join. Thank you, everyone, and we will speak to you soon. Bye for now. Bye.(MUSIC PLAYS) Thank you for listening to this episode of the Making Visible Podcast. All client experiences discussed in making Visible have been de-identified. The content discussed in this podcast may be distressing. If you live in Australia and need support. Please contact 1800 RESPECT, 1800 737 732 or lifeline on 131114. Making Visible is produced by the Agency for Clinical Innovations Violence Abuse and Neglect Network in partnership with the University of Wollongong and the Social Work Stories Podcast Team.